Canis ISSN: 2398-2942

Dietetic diet: for chronic kidney disease (CKD)

Contributor(s): Marge Chandler

Pathophysiology

  • While the underlying cause of most cases of canine CKD Kidney: chronic kidney disease (CKD) remains obscure, a number of different etiologies have been documented, eg dysplasia Kidney: dysplasia , glomerulopathy, chronic tubulointerstitial disorders, pyelonephritis Kidney: pyelonephritis , polycystic renal disease Kidney: polycystic disease (congenital or acquired), amyloidosis Amyloidosis (familial or acquired), cystadenocarcinoma (German shepherd dogs) nephrotoxins (eg ethylene glycol Ethylene glycol poisoning , aminoglycoside antibiotics, grapes raisins Raisin poisoning , hypercalcemia Hypercalcemia: overview , hydronephrosis Hydronephrosis / hydroureter (eg from a blocked ureter), renal ischemia Kidney: ischemia , renal lymphoma or carcinoma Kidney: neoplasia , and as an eventual result of untreated pre-renal or post-renal failure.
  • As the renal function Renal function assessment decreases to less than about 1/3 of normal, the ability of the nephrons to concentrate urine decreases and the urine becomes less concentrated, resulting in polyuria and a secondary polydipsia.
  • Potassium and B vitamins are lost in increasing amounts as the amount of urine produced increases, and may result in deficiencies.
  • When the glomerular filtration rate (GFR) drops below 25% of normal, metabolites and uremic toxins may accumulate. These include the metabolic products of protein metabolism which are reflected in the serum as increased urea and creatinine.
  • As the GFR decreases to less than about 15%, the excretion of phosphorus decreases and serum phosphorus increases.
  • Along with the retention of phosphorus, parathyroid hormone concentrations may increase (renal secondary hyperparathyroidism Renal secondary hyperparathyroidism , contributing to signs of uremia Uremia. Production of erythropoitin from the kidneys may decrease resulting in a non-regenerative anemia Anemia: non-regenerative.
  • Decreased production of calcitriol (vitamin D) may contribute to renal secondary hyperparathyroidism.
  • Dehydration and loss of bicarbonate leads to a tendency for metabolic acidosis Acid base imbalance.
  • Signs of chronic kidney disease include polyuria, polydipsia, weight loss, poor appetite, hypertension Hypertension , weakness, and anemia.
  • Therapeutic interventions may be based upon the International Renal Interest Society (IRIS), although the strength of evidence varies among treatments.

Dietary requirements

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Special considerations

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Diet for dogs with chronic kidney disease

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Further Reading

Publications

Refereed papers

Other sources of information

  • Elliott D A ( 2012)Nutritional management of kidney disease.In: Applied Veterinary Clinical Nutrition.Editors Fascetti AJ and Delaney SJ. Wiley Blackwell , West Sussex, UK. pp 251-268.
  • Polzin D J, Osborne C A, Ross S (2009)Evidence-based management of chronic kidney disease.In: Kirk's Current Veterinary Therapy XIV.Editors Bonagura JD, Twedt DC. Saunders Elsevier, St Louis, Mo. pp872-879.
  • Squires R A (1996)Uraemia.In: BSAVA Manual of Canine and Feline Nephrology and Urology.Editors: Bainbridge J and Elliott J. BSAVA, Gloucestershire, UK. pp52-67.


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